title: Importance of creatinine clearance for drug dosing in nursing home residents.
abstract: Serum creatinine is often not an adequate measure of renal function, especially in advanced age or in physically debilitated patients. Estimated creatinine clearance is necessary to decide on usage of drugs such as Metformin. This study included 64 nursing home residents with diabetes treated with Metformin. Creatinine clearance (CrCl) was calculated by the Cockcroft-Gault equation modified for ideal body weight. CrCl more than or equal to 60/mL min was used as a cut-off for appropriate use of Metformin. In our sample, 20.3% had renal failure when measured by serum creatinine while 56.3% had renal failure when measured by CrCl. Age >65 years and women were more likely to be classified as normal for serum creatinine but have abnormal creatinine clearance. Use of estimated creatinine clearance should be advocated instead of serum creatinine when prescribing Metformin, especially for those of older age and among women.
authors.affiliation: Division of Nephrology, Nassau University Medical Center , East Meadow, NY , USA and.
authors.forename: Jignesh
authors.initials: J
authors.lastname: Shah
authors.forename: Joshua
authors.initials: J
authors.lastname: Fogel
authors.forename: Leah
authors.initials: L
authors.lastname: Balsam
mesh_terms: D000368:Aged; D054316:Biomarkers, Pharmacological / Q000097:blood*; D000075202:Contraindications; D003404:Creatinine / Q000097:blood*; D003430:Cross-Sectional Studies; D003920:Diabetes Mellitus / Q000097:blood / Q000188:drug therapy*; D005260:Female; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D007297:Inpatients; D007677:Kidney Function Tests; D008297:Male; D008687:Metformin / Q000627:therapeutic use*; D008875:Middle Aged; D009735:Nursing Homes; D012189:Retrospective Studies
chemical_list: D054316:Biomarkers, Pharmacological; D007004:Hypoglycemic Agents; D008687:Metformin; D003404:Creatinine